Active NPI
Kacey Marie Jacques, PT
- Physical Therapist
- Monument, CO
National Provider Identifier
1902128622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTL0015090
- Practice address
- 1889 Woodmoor Dr
Monument, CO 80132-9066 - Phone
- (719) 481-6868
- NPI assigned
- Feb 22, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | 14531 | CA | |
| Pediatric Physical Therapist | 2251P0200X | 14531 | CA | |
| Ergonomics Physical Therapist | 2251E1200X | 14531 | CA | |
| Orthopedic Physical Therapist | 2251X0800X | 14531 | CA | |
| Physical Therapist | 225100000X | PTL0015090 | CO | Primary |
Addresses
Primary practice location
1889 Woodmoor Dr
Monument, CO 80132-9066
Mailing address
6340 Variel Ave
Woodland Hills, CA 91367-2514
Phone (818) 888-1255
Other practice location 1
6340 Variel Ave
Woodland Hills, CA 91367-2514
Phone (818) 888-4559
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5359 Balboa Blvd
Suite a
Encino, CA 91316-2834
Phone (310) 273-0877
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTL0015090 | CO | MD | Physical Therapist |
| 14531 | CA | MD | Acute Care Nurse Practitioner |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Beverly Hills, CA
- NPI 1487717153
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773100800000",
"number": "1902128622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6340 VARIEL AVE",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913672514",
"telephone_number": "818-888-1255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1889 WOODMOOR DR",
"city": "MONUMENT",
"state": "CO",
"postal_code": "801329066",
"telephone_number": "719-481-6868"
}
],
"practiceLocations": [
{
"address_1": "6340 Variel Ave",
"address_purpose": "LOCATION",
"city": "Woodland Hills",
"state": "CA",
"postal_code": "913672514",
"country_code": "US",
"telephone_number": "818-888-4559",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACQUES",
"first_name": "KACEY",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-22",
"last_updated": "2026-03-10",
"certification_date": "2026-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "CA",
"license": "14531",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CA",
"license": "14531",
"primary": false
},
{
"code": "2251E1200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Ergonomics",
"state": "CA",
"license": "14531",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "14531",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "PTL0015090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Monument, CO
- Dylan Alexander Jachimek
- Jackson Creek Assisted Living, LLC (Jackson Creek Senior Living)
- Jackson Creek Dental Care, P.C. (Jackson Creek Dental Care)
- Catherine Jackson
- Jenna Jackson, LPC
- Warren Jaeger, MD
- Jah Wellness PLLC
- Amber R James, M.ED, LPC, NCC
- Jasmine Chantel Jaquess, LPCC
- Elizabeth Jarka, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.